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CAPS Policy – Program Integrity No.: CAPS/00-16 Effective Date: 10/01/2016 Revised: 03/02/2026 Revision Effective: 03/02/2026

CAPS Policy Manual

Page 100 of 109 16.5.5.2 DECAL has the right to enter into repayment agreements with child care providers to ensure that all claims are collected in full and within 24 months. 16.5.5.3 Providers may complete the Child Care Provider Repayment Statement to determine the amount and frequency of claim payments. The provider must adhere to all terms of the repayment statement. 16.5.5.4 Claims may be repaid through offsetting reimbursements, a lump sum, or, in limited situations, monthly installments. Offsetting reduces the CAPS reimbursement until the claim has been repaid in full and is only available for providers currently receiving subsidy. Information regarding payment arrangements for a lump sum or monthly installments can be found in CAPS Managing Program Integrity Procedure (CAPS/01-08).

Automation Errors, Administrative Errors, and Underpayments 16.6.1 The provider shall refund any overpayments assessed by DECAL or its representatives related to automation errors. 16.6.2 Administrative errors are a result of an error made by the agency causing incorrect payment of subsidy and/or eligibility to be determined incorrectly. In cases where the claim is completely based on an administrative error, the agency will not seek recoupment. However, the case will be corrected to ensure accuracy and compliance with applicable laws, regulations, and policies. 16.6.3 An underpayment exists when an improper payment is discovered where the parent or child care provider receives fewer services or less payment than she or he is entitled to receive. If benefits are underpaid due to an administrative error, the amount owed shall be paid within 30 calendar days from the date the error was discovered, unless more information is needed to calculate the correct payment or the parent or the child care provider has an outstanding overpayment. 16.6.3.1 Underpayments will first be used to offset any outstanding overpayment.

POLICY REVISION HISTORY Date Description of Change 07/02/2018 Revised policy to indicate that DECAL will not seek recoupment for any claims based completely on administrative error. Previously, policy stated that DECAL would seek recoupment if the claim based completely on administrative error exceeded $600. 10/01/2018 Added Serious Injury to the list of disqualifying circumstances. This is included in the CAPS Health and Safety Policy (CAPS/00-15). 02/01/2019 Reorganized policy by replacing Improper Payments (CAPS/00-15) and Disqualifications and Sanctions (CAPS/00-16) policies with Health and Safety Standards (CAPS/00-15) and Program Integrity (CAPS/00- 16) policies. This new Program Integrity Policy is composed primarily of relevant information that already existed in other sections of CAPS policy. In addition to centralizing existing policies, we added details regarding prevention, detection, and investigation processes that were already in practice within the CAPS program but were not outlined in CAPS policy. 07/01/2019 Revised language to clarify CAPS policy regarding dismissal and disqualifications from CAPS due to termination or disqualification by the Office of Inspector General (OIG) with the U.S. Department of Health and Human Services, by the Child and Adult Care Food Program (CACFP), or by the Summer Food Service Program (SFSP). 10/1/2019 Added language noting that DECAL may place providers in a probationary status. Clarified that a case may close when a parental authority fails to respond to the child care claim or repayment statement. Revised language to reflect the appeal period is the deadline listed on the notice or within 14 calendar days from the date of the notice on an appealable or adverse action taken by DECAL.